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  • 1.
    Andersson, Jenny
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Fjellström, Christina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Gustafsson, Kerstin
    Sidenvall, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Subjective, qualitative and quantitative methods to evaluate elderly women's meals in relation to energy2000In: 4th Conference on Dietary Assessment Methods. Tucson, Arizona, USA. 17-20 September 2000, 2000Conference paper (Other academic)
    Abstract
  • 2.
    Andersson, Jenny
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences. avd för kost.
    Gustafsson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fjellström, Christina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Sidenvall, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Five-day food intake in elderly female outpatients with Parkinson´s disease, rheumatoid arthritis or stroke2004In: The Journal of Nutrition, Health and Aging, Vol. 8, no 5, p. 414-421Article in journal (Refereed)
  • 3.
    Andersson, Jenny
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Gustafsson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fjellström, Christina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Sidenvall, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Five-day food intake in elderly female outpatients with Parkinson's disease, rheumatoid arthritis or stroke2004In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 8, no 5, p. 414-421Article in journal (Refereed)
    Abstract [en]

    AIM:

    The aim of this study was to describe and analyse the intake of food, energy and selected nutrients in elderly outpatients, i.e. women with Parkinson's disease, rheumatoid arthritis or stroke.

    SUBJECTS AND METHODS:

    Sixty-three elderly women aged 64-88 years participated in the study. For assessing dietary intake, a repeated 24-h recall and an estimated food diary for three consecutive days were used.

    RESULTS:

    The mean age was 73.4 +/- 6.6 years. Mean reported daily energy intake was 6.4 +/- 1.7 MJ, i.e. lower than reference figures for all groups. However, looking at nutrient density, only intakes of vitamin E and folate were below recommended levels. The most frequently consumed food groups were bread, coffee, milk products, buns and cookies, and spreads.

    CONCLUSION:

    The reported energy intake among the elderly female outpatients was low. This might be explained by actual low intake and/or under-reporting. However, the intake of most vitamins and minerals, i.e. nutrient density, was adequate, with the exception of vitamin E and folate intake, which was below recommended levels. Food intake showed large variation and good diet composition, and there was a tendency towards high consumption of food items that are easily prepared and eaten.

  • 4.
    Andersson, Jenny
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Gustafsson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sidenvall, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fjellström, Christina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Meals and snacks among elderly self-managing and disabled women2003In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 41, no 2, p. 149-160Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to describe the frequency and distribution of self-managing and disabled elderly women's eating events, as well as to investigate which definition/names the women had given their different eating events and to categorise these into meals and snacks. An additional aim was to study the composition of meals and snacks, and analyse the nutritional significance of these eating events in terms of energy and macronutrients.

    Subjects. Elderly women, both self-managing (n=139) and disabled (n=63; with Parkinson's disease, rheumatoid arthritis or stroke), aged 64–88 years, and living at home participated.

    Methods. A repeated 24 h recall and an estimated food diary for three consecutive days were used.

    Results. The eating events defined by the women that were categorised as meals contributed 74% of the total daily energy intake, while snacks contributed 22–23%. The meals that the women had defined as dinner, was the most energy dense meal. The frequency of eating events not defined by the women, was 30–34%, but contributed only 3–4% of the total daily energy intake. The disabled women had a significantly lower energy content in meals and most snacks, compared to the self-managing women.

    Conclusion. The main conclusion was that elderly women still living at home had their meals distributed during the day and that these meals were characterised by individuality and flexibility.

  • 5.
    Fielding, R. A.
    et al.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, 711 Washington St, Boston, MA 02111 USA..
    Travison, T. G.
    Hebrew SeniorLife, Inst Aging Res, Boston, MA USA.;Harvard Med Sch, Boston, MA USA..
    Kirn, D. R.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, 711 Washington St, Boston, MA 02111 USA..
    Koochek, A.
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Clin Nutr & Metab, Uppsala, Sweden..
    Reid, K. F.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, 711 Washington St, Boston, MA 02111 USA..
    von Berens, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Zhu, H.
    Hebrew SeniorLife, Inst Aging Res, Boston, MA USA..
    Folta, S. C.
    Tufts Univ, Friedman Sch Nutr Sci & Policy, 711 Washington St, Boston, MA 02111 USA..
    Sacheck, J. M.
    Tufts Univ, Friedman Sch Nutr Sci & Policy, 711 Washington St, Boston, MA 02111 USA..
    Nelson, M. E.
    Tufts Univ, Friedman Sch Nutr Sci & Policy, 711 Washington St, Boston, MA 02111 USA.;Univ New Hampshire, Sustainabil Inst, Durham, NH 03824 USA..
    Liu, C. K.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, 711 Washington St, Boston, MA 02111 USA.;Boston Univ, Sch Med, Sect Geriatr, Boston, MA 02118 USA..
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. School of Education, Health and Society, Dalarna University, Sweden.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. School of Education, Health and Society, Dalarna University, Sweden.
    Lilja, M.
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden..
    Gustafsson, T.
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden..
    Cederholm, Tommy E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Effect of structured physical activity and nutritional supplementation on physical function in mobility-limited older adults: Results from the VIVE2 randomized trial2017In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no 9, p. 936-942Article in journal (Refereed)
    Abstract [en]

    The interactions between nutritional supplementation and physical activity on changes in physical function among older adults remain unclear. The primary objective of this study was to examine the impact of nutritional supplementation plus structured physical activity on 400M walk capacity in mobility-limited older adults across two sites (Boston, USA and Stockholm, Sweden). All subjects participated in a physical activity program (3x/week for 24 weeks), involving walking, strength, balance, and flexibility exercises. Subjects were randomized to a daily nutritional supplement (150kcal, 20g whey protein, 800 IU vitamin D) or placebo (30kcal, non-nutritive). Participants were recruited from urban communities at 2 field centers in Boston MA USA and Stockholm SWE. Mobility-limited (Short Physical Performance Battery (SPPB) ae<currency>9) and vitamin D insufficient (serum 25(OH) D 9 - 24 ng/ml) older adults were recruited for this study. Primary outcome was gait speed assessed by the 400M walk. Results: 149 subjects were randomized into the study (mean age=77.5 +/- 5.4; female=46.3%; mean SPPB= 7.9 +/- 1.2; mean 25(OH)D=18.7 +/- 6.4 ng/ml). Adherence across supplement and placebo groups was similar (86% and 88%, respectively), and was also similar across groups for the physical activity intervention (75% and 72%, respectively). Both groups demonstrated an improvement in gait speed with no significant difference between those who received the nutritional supplement compared to the placebo (0.071 and 0.108 m/s, respectively (p=0.06)). Similar effects in physical function were observed using the SPPB. Serum 25(OH)D increased in supplemented group compared to placebo 7.4 ng/ml versus 1.3 ng/ml respectively. Results suggest improved gait speed following physical activity program with no further improvement with added nutritional supplementation.

  • 6.
    Frid, Hanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Thors Adolfsson, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Agreement between different methods of measuring height in elderly patients2013In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 26, no 5, p. 504-511Article in journal (Refereed)
    Abstract [en]

    Background

    The present study aimed to examine the agreement between measurements of standing height and self-reported height, height measured with a sliding caliper, and height estimated from either demispan or knee height in elderly patients.

    Methods

    Fifty-five patients (mean age 79 years) at a Swedish hospital were included in this observational study. The participants' heights were evaluated as the standing height, self-reported height, height measured in a recumbent position with a sliding caliper, and height estimated from the demispan or knee height.

    Results

    The measurements made with a sliding caliper in the recumbent position agreed most closely with the standing height. Ninety-five percent of the individuals' differences from standing height were within an interval of +1.1 to −4.8 cm (limits of agreement). Self-reported height and height estimated from knee height differed relatively strongly from standing height. The limits of agreement were +5.2 to −9.8 cm and +9.4 to −6.2 cm, respectively. The widest distribution of differences was found in the height estimated from the demispan, with limits of agreements from +11.2 to −9.3 cm.

    Conclusions

    When measuring the height of patients who find it difficult to stand upright, a sliding caliper should be the method of choice, and the second choice should be self-reported height or the height estimated from knee height. Estimating height from the demispan should be the method of last resort.

  • 7.
    Gustafsson, Kerstin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Andersson, Jenny
    Andersson, Ingegerd
    Nydahl, Margaretha
    Sjödén, Per-Olow
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Sidenvall, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Associations between perceived cooking ability, dietary intake and meal patterns among older women2002In: Scandinavian Journal of Nutrition, Vol. 46, no 1, p. 31-Article in journal (Refereed)
  • 8.
    Hedman, Sanna
    et al.
    Department of Clinical Nutrition and dietetics, Karolinska University Hospital, Stockholm, Sweden.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Faxén-Irving, Gerd
    Division of Clinical Geriatrics, department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients2016In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 35, no 3, p. 692-698Article in journal (Refereed)
    Abstract [en]

    Background & aims

    Malnutrition is a well-recognized problem in geriatric patients. Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients. The objective of this study was to investigate routines regarding dietary prescriptions and monitoring of food intake in geriatric patients and to see how well the prescribed diet conforms to the patients' nutritional status and ability to eat. A further aim was to identify the most common reasons and factors interacting with patients not finishing a complete meal.

    Methods

    This study combines two methods using both qualitative and quantitative analysis. Patients (n = 43; 82.5 ± 7.5 yrs; 60% females) at four geriatric wards performed a two-day dietary record, assisted by a dietician. Nurses and assistant nurses at each ward participated in a semi-structured interview regarding prescription of diets and portion size for the patients.

    Results

    The prescribed diet differed significantly (P < 0.01) from a diet based upon the patient's nutritional status and ability to eat. Only 30% of the patients were prescribed an energy-enriched diet in contrast to 60% that was in need of it. The most common reason for not finishing the meal was lack of appetite. Diet prescription for the patient was based upon information about eating difficulties identified in the Mini Nutritional Assessment-Short Form (MNA-SF) at admission and the type of diet that was prescribed on a previous ward. Monitoring of the patients' food intake was described as a continuous process discussed daily between the staff.

    Conclusion

    Patients' nutritional status and to what extent they were able to eat a complete meal was not routinely considered when prescribing food and monitoring food intake in this study. By making use of this information the diet could be tailored to the patients' needs, thereby improving their nutritional treatment.

  • 9.
    Liljeberg, Evelina
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Function Area Clinical Nutrition, Karolinska University Hospital, Norrbacka S1:03, SE-17176 Stockholm, Sweden.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lövestam, Elin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Incomplete descriptions of oral nutritional supplement interventions in reports of randomised controlled trials2018In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 37, no 1, p. 61-71Article in journal (Refereed)
    Abstract [en]

    Background & aims

    The effects of oral nutritional supplements (ONS) have been evaluated in several clinical trials and more studies have been requested. To facilitate replication, support accurate evaluations of research results and avoid research waste, high quality reporting of interventions in clinical trials is needed. The aim of this study is to assess the quality of reporting of interventions in publications describing randomised controlled trials of ONS in populations with malnutrition or at nutritional risk.

    Methods

    The PubMed database was searched for articles describing ONS trials published between January 2002 and December 2015. The quality of intervention descriptions was evaluated using the Template for Intervention Description and Replication (TIDieR) checklist and guide, which contains twelve items. Articles published before and after 2011 were compared.

    Results

    Of 76 articles identified, only 3% reported all TIDieR items in sufficient detail. The most frequently missing elements were descriptions of the intervention procedures (e.g. how the ONS were to be taken and if participants were given a choice of flavours), which were adequately presented in only 26% of the articles. Less than half of the articles included a description of the intervention provider and sufficient information about the location(s) for the intervention. Information about adherence and mode of delivery was reported in 60–65% of the articles. Most frequently reported, in >70% of the articles, were items regarding the brief name of the intervention, the rationale for the intervention and the materials used (i.e. information about the specific ONS product(s) administered). The reporting quality for two of the items (materials and provider) was higher in articles published after 2011.

    Conclusions

    The quality of reporting of ONS interventions was found to be poor. The descriptions mostly lacked information about intervention procedures, provider and location(s). A moderately higher reporting quality was observed in articles published after 2011. These findings imply that an improvement in the descriptions of ONS interventions is required in future clinical trials of malnutrition treatment.

  • 10.
    Liljeberg, Evelina
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics. Function Area Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics.
    Malmberg, Karin Blom
    Department of Clinical Nutrition, Uppsala University Hospital, Uppsala, Sweden.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics.
    High adherence to oral nutrition supplements prescribed by dietitians:: A cross‐sectional study on hospital outpatients2019In: Nutrition in clinical practice, ISSN 0884-5336, Vol. 34, no 6, p. 887-898Article in journal (Refereed)
    Abstract [en]

    Background: This study aimed to assess adherence to oral nutrition supplements (ONS) among hospital outpatients and to assess patient characteristics, experiences of ONS, and the characteristics of ONS prescriptions in clinical practice.

    Methods: Hospital outpatients aged 18 years and prescribed ONS by a dietitian at a Swedish hospital were referred to the study from September 2016 to February 2017. Data were collected from structured telephone interviews, medical records, and a register of ONS delivered. Adherence to ONS was measured by dividing self-reported intake of ONS (frequency question and 24-hour recall question) by the amount prescribed and using the medication possession ratio (MPR).

    Results: Of the 96 patients included (mean age 67±13 years), 52% were male. The 2 most frequent medical diagnoses were malignancy and digestive system disease. Mean adherence to ONS was 93% measured by the frequency question, 87% measured by the 24-hour recall question, and 76% according to MPR. The majority of the patients (83%) were prescribed 1–3 bottles of ONS/day. The average number of flavors of ONS delivered was 4.2. Before prescription, 69% of the patients had been allowed to taste the ONS and 92% had chosen the flavors to be prescribed. Over 75% liked the taste of the ONS and considered them to be good for their health.

    Conclusions: Adherence to ONS was high in this population, which might be explained by the individual tailoring of ONS prescriptions by a dietitian, positive experiences of ONS, and the relatively young mean age of the participants.

  • 11.
    Liljeberg, Evelina
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Adherence to oral nutritional supplements among hospital outpatients2018Conference paper (Refereed)
    Abstract
  • 12.
    Liljeberg, Evelina
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Factors associated with adherence to oral nutritional supplements among free-living hospital outpatients2019In: ASPEN 2019 Nutrition Science and Practice Conference: Phoenix, Arizona 23-26 March, 2019: Vars Candidates, Trainee Awards, Best of ASPEN (Topic Awards), International Awards, Abstracts of Distinction, Posters of Distinction and Other Abstracts / [ed] Journal of Parenteral and Enteral Nutrition, 2019, Vol. 43, p. 445-445, article id 10.1002/jpen.1511Conference paper (Other academic)
  • 13.
    Marklinder, Ingela
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lundmark, Linda
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Cold Food Storage - the 70+ need for Information2008In: IAFP´s Fourth European Symposium on Food Safety, Lisbon, Portugal 19-21 November 2008, 2008, p. 8-8Conference paper (Other academic)
    Abstract [en]

    Older people (70 years plus) represent a risk category concerning complications with food-borne infections. As part of the project CHANCE, taking place in Austria, Germany, Latvia, Romania, Sweden and United Kingdom (Lifelong Learning Programme of European Union 2007-2009) a pilot study was performed in the urban area of Eriksberg, Uppsala municipality, Sweden. The aim was to understand this target group’s need for information about cold food storage and food handling within the context of understanding and perception of health related messages.

    Methods: Nine individuals aged 72 -93 years were individually asked to purchase certain food items (soft cheese; vacuum-packed, smoked salmon; vacuum-packed, sliced ham) and store them in their own refrigerator using their normal food practices. Subsequently, qualitative interviews were performed. The temperature was then measured in these food items after storage for one night.   Data were qualitatively processed.

    Results: The study group were neither aware of the temperature in their refrigerator nor did they know about temperature differences on different shelves, although they did consider themselves to have a sound knowledge of how to handle and store foods.  They expressed confidence in the grocery store and as such did not see the need for information. None of the informants were afraid of food-borne infections and yet a common habit was to taste raw minced meat, thus indicating a risk related optimism. The recorded temperatures of the various foodstuffs also suggested need for extra information.

    Significance: This group seemed to overestimate their own skills concerning cold food storage. Education about food handling was taught in childhood but arguably a need for information about how to handle food today exists. The trust given to their grocery store might contribute to a decrease in their own responsibility, which might be an obstacle concerning accessing further information.

     

  • 14.
    Marklinder, Ingela
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Magnusson, Maria
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    CHANCE: a healthy lifestyle in terms of food handling and hygiene2013In: British Food Journal, ISSN 0007-070X, E-ISSN 1758-4108, Vol. 115, no 2-3, p. 223-234Article in journal (Refereed)
    Abstract [en]

    The purpose of this paper is to identify knowledge gaps in terms of food handling and hygiene among a population in a selected city district. This study is a part of the project Community Health management to Enhance Behaviour (CHANCE), Life Long Learning programme of European Union 2007-2009). A certain vulnerable group, i.e. older people , were addressed. the study population was recruited by convenience sample. A questionnaire was used to collect data among citizens in a selected city district (n=251). The elderly (71-80+; n=123) were interviewed face to face, while the younger (21-70 years; n= 128) filled in their data on their own.

    One third of the respondents usually measure the temperature in their trefrigerator. However, one third revealed knowledge gaps relating to storage temperature for certain food items. Thirty nine per cent changes dishcloths onece a week. Twenty percent of the elderly usually put raw minced meat into their mouth without reflecting on pathogenic bacteria. There was no significant relation between the fear of food poisioning and tasting minced meat, changing the dishcloth often, or cooling down food properly. These results can be interpreted as a sign of knowledge gaps, indicating a need for imporved health communication.

    The study population consisted of consumers in a selected city district in Uppsala municipality. Therefore the results should not be generalized for Swedes in general. The collected data and the information of knowledge gaps have been used to perform a local health intervention. The results would reveal relevance for a larger nationwide survey that aims to identify knowledge gaps in terms of food handling and and hygiene among Swedish citizens. Data from the present study would be useful in the attempt to implement simple tools at the local level, in order to promote healthy habits among consumers. An innovative principle in the EU project CHANCE is to work from inside out. Studies of consumers´food handling in private homes are lacking in Sweden. the present study is rather unique as it explores private households in terms of food handling and hygiene.

  • 15.
    Marklinder, Ingela
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Sweden Community of Eriksberg2009Conference paper (Other academic)
  • 16.
    Marklinder, Ingela
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Freytag-Leyer, Barbara
    Fulda university of Applied Sciences.
    Elmfada, Ibrahim
    Universität Vienna.
    Rust, Petra
    Universität Vienna.
    Dangschat, Jens
    Technical University of Vienna.
    Hertzsch, Wencke
    Technical University of Vienna.
    Klotter, Christoph
    Fulda university of Applied Sciences.
    Alisch, Monika
    Fulda university of Applied Sciences.
    Hampshire, Jörg
    Fulda university of Applied Sciences.
    Eglite, Aija
    Agriculture University of Jelgava.
    Pilvere, Irina
    Agriculture University of Jelgava.
    Vintila, Mona
    west University of Timisoara.
    Hackett, Allan
    Liverpool John Moores University.
    Meadows, Mark
    Liverpool John Moores University.
    Richards, Jackie
    Liverpool John Moores University.
    Lybert, Pauline
    Liverpool John Moores University.
    Stevenson, Leo
    Liverpool John Moores University.
    Project CHANCE Community Health Management to Enhance Behaviour: CHANCE2009Report (Other academic)
  • 17.
    Marklinder, Ingela
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lundmark, Linda
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Cold food storage - the 70+ Need for Information.2008In: Proceedings at the IAFP´s Fourth Symposium on Food safety 19-21 Nov. 2008, Advancements in Food Safety Lisbon, Portugal, 2008Conference paper (Refereed)
    Abstract [en]

    Older people (70 years plus) represent a risk category concerning complications with foodborne infections. As part of the project CHANCE, taking place in Austria, Germany, Latvia, Romania, Sweden and United Kingdom (Lifelong Learning Programme of European Union 2007–2009) a pilot study was performed in the urban area Eriksberg, Uppsala municipality, Sweden. The aim was to understand this target group’s need for information about cold food storage and food handling within the context of understanding and perception of health related messages.

    Methods 

    Nine individuals 72–93 years were individually asked to purchase certain food items(soft cheese; vacuum-packed, smoked salmon; vacuum-packed, sliced ham) and store them in their own refrigerator using their normal food practices. Subsequently, qualitative interviews were performed. The temperature was then measured in these food items after storage for one night. Data were qualitatively processed.

    Results

    The study group were neither aware of the temperature in their refrigerator nor did they know about temperature differences on different shelves, although they did consider themselves to have a sound knowledge of how to handle and store foods. They expressed confidence in the grocery store and as such did not see the need for information. None of the informants were afraid of food-borne infections and yet a common habit was to taste raw minced meat, thus indicating a risk related optimism. The recorded temperatures of the various foodstuffs also suggested need for extra information.

    Significance

    This group seemed to overestimate their own skills concerning cold food storage. Education about food handling was taught in childhood but arguably a need for information about how to handle food today exists. The trust given to their grocery store might contribute to a decrease in their own responsibility, which might be an obstacle concerning accessing further information.

  • 18.
    Marklinder, Ingela
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences.
    Persson, Inger
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences.
    Thelin, Erika
    Wiström, Anna
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences.
    Low fruit & vegetable consumption and risky food safety behaviour - older people should be included in helth communication2014Conference paper (Other academic)
  • 19.
    Mattsson Sydner, Ylva
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Andersson, Jenny
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Gustafsson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Sidenvall, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fjellström, Christina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Quality of Life management of Living Resource (SENIOR FOOD-QOL). Determining the role of meals in later life2004In: The 8th Nordic Nutrition Conference, Tönsberg, Norway 20-23 June 2004., 2004Conference paper (Refereed)
  • 20.
    Nydahl, M
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Andersson, J.
    Sidenvall, B.
    Gustafsson, K.
    Fjellström, C.
    Food and nutrient intake in a group of self-managing elderly Swedish women.2003In: International Academy Nutrition and Aging. Newsletter.Article, book review (Other (popular science, discussion, etc.))
  • 21.
    Nydahl, Margaretha
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Amneus, Sandra
    Johansson, Malin
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Health communication in relation to healthy eating among elderly2013In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321, Vol. 28, no SI, p. 281-282Article in journal (Other academic)
  • 22.
    Nydahl, Margaretha
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Andersson, Jenny
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Fjellström, Christina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Gustafsson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Mattsson Sydner, Ylva
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Sidenvall, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Quality of Life and Management of Living Resources: Choosing foods, eating meals: sustaining independence and quality of life in old age-an EU funded project2004In: The 8th Nordic Nutrition Conference, 2004Conference paper (Refereed)
  • 23.
    Nydahl, Margaretha
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Andersson, Jenny
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Sidenvall, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Gustafsson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fjellström, Christina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Food and nutrient intake in a group of self-managing elderly Swedish women2003In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 7, no 2, p. 67-74Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: With the increasing numbers of elderly women living at home, there is an interest to investigate the dietary intake of this group.

    OBJECTIVE: To investigate the food and nutrient intake in a group of self-managing elderly women in Sweden.

    DESIGN: A 3-day self-reported food diary and a repeated 24-h dietary recall were used. The study comprised 135 single-living or married/cohabiting women (mean age 79.5 8.0 years).

    RESULTS: Mean energy intake for the whole group was 6.8 1.9 MJ, and low energy figures were obtained in all age groups indicating some possible under-reporting with a calculated EIrep/BMRest of 1.24 0.36 for the whole group. Overall, energy and nutrient intake was similar in the different age groups (64-68 yrs, 74-78 yrs and 84-88 yrs). Reported intakes of vitamin D (4.8 2.7 mg), tocopherol (5.9 2.2 mg), iron (8.5 2.9 mg), folate (200 8.7 mg) and selenium (29 11 mg) were low compared to recommended intakes. Only minor differences between women in different household types were found. The women reported a variety of food items in their diet.

    CONCLUSIONS: Overall, the results from this study indicate that self-managing elderly women report low energy figures, but have a sufficient intake of most nutrients. However, there is a tendency that the oldest women, i.e. 84-88 yrs have lower intakes.

  • 24.
    Nydahl, Margaretha
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Jacobsson, Fanny
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lindblom, Marielle
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    A simplified health information model increased the level of knowledge regarding "five a day" and food safety in a city district2012In: British Food Journal, ISSN 0007-070X, E-ISSN 1758-4108, Vol. 114, no 7, p. 910-925Article in journal (Refereed)
    Abstract [en]

    Purpose – The aim of this paper was to analyze the effect according to knowledge and behavior, respectively, through a simplified health information model launched in a selected city district.

    Design/methodology/approach – The intervention in this study encompasses information meetings where two educational computer programs highlighting the “five a day” concept, and food hygiene were showcased in conjunction with a group discussion. In total, 92 people living or working in a selected city district participated. The effect of the intervention was determined by means of inquiries (multiple-choice) that were carried out prior to, immediately following, and three weeks after the intervention.

    Findings – A statistically significant improvement in knowledge of the concepts “five a day”, cross-contamination, and recommended storage temperature (for smoked salmon and raw mince meat) was observed, however, no major change in behavior was reported.

    Practical implications – The knowledge improvement suggests that the education programs, in conjunction with discussions, are a useful information model for raising awareness about the notion of “five a day” and food safety. The results of the study make it clear that there are difficulties in getting people to change their behavior, let alone getting them to participate in health education offered locally.

    Originality/value – Intervention projects are a communication tool that may be used in order to increase knowledge and produce behavioral change. The project is working from the inside out, i.e. it examines the needs first and then develops solutions for them.

  • 25.
    Sandvik, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Kihlberg, Iwona
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lindroos, Anna Karin
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Bread consumption patterns in a Swedish national dietary survey focusing particularly on whole-grain and rye bread2014In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58, p. 24024-Article in journal (Refereed)
    Abstract [en]

    Background: Bread types with high contents of whole grains and rye are associated with beneficial health effects. Consumer characteristics of different bread consumption patterns are however not well known.

    Objective: To compare bread consumption patterns among Swedish adults in relation to selected socio-demographic, geographic, and lifestyle-related factors. For selected consumer groups, the further aim is to investigate the intake of whole grains and the context of bread consumption, that is, where and when it is consumed.

    Design: Secondary analysis was performed on bread consumption data from a national dietary survey (n=1,435). Respondents were segmented into consumer groups according to the type and amount of bread consumed. Multiple logistic regressions were performed to study how selected socio-demographic, geographic, and lifestyle-related factors were associated with the consumer groups. Selected consumption groups were compared in terms of whole-grain intake and consumption context. Consumption in different age groups was analysed more in detail.

    Results: One-third of the respondents consumed mainly white bread. Socio-demographic, geographic, and healthy-lifestyle-related factors were associated with the bread type consumed. White bread consumption was associated with younger age groups, less education, children in the family, eating less fruit and vegetables, and more candy and snacks; the opposite was seen for mainly whole-grain bread consumers. Older age groups more often reported eating dry crisp bread, whole-grain bread, and whole-grain rye bread with sourdough whereas younger respondents reported eating bread outside the home, something that also mainly white bread eaters did. Low consumers of bread also consumed less whole grain in total.

    Conclusions: Traditional bread consumption structures were observed, as was a transition among young consumers who more often consumed fast food bread and bread outside the home, as well as less rye and whole-grain bread. Target groups for communication strategies and product development of more sensorily attractive rye or whole-grain-rich bread should be younger age groups (18–30 years), families with children, and groups with lower educational levels.

  • 26.
    Sandvik, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Kihlberg, Iwona
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Quality perception of bread among Swedish consumers in the light of the carbohydrate debate2012Conference paper (Refereed)
    Abstract [en]

    The current carbohydrate debate causes difficulties for the consumer to make the right choices in terms of carbohydrate quality, which can lead to the exclusion of bread from the diet. Media has been a major arena for these debates, promoting low carbohydrate diets.

    Rye has many interesting health promoting components such as bioactive components and fibers and has shown to be beneficial on insulinemic response, satiety, and bowel health. An increased consumption of rye bread might promote public health and therefore it is important to elucidate the difference between different kinds of carbohydrates. 

    A positive quality perception is a presumption for consumption. Knowledge about consumer quality perception is important for product development and from a public health perspective, to influence the consumer to make healthy choices. Sensory, and health related factors have shown to be important for the quality perception of bread, and consumers’ use different cues to evaluate the quality before consumption.

    The aim is to study Swedish consumers’ quality perception of bread with focus on soft bread, in the light of the carbohydrate debate. A questionnaire with three sections was developed and piloted. The first section contained questions of consumption behavior for bread and other carbohydrate rich foods. In the second section product cues for choice, health, taste and satiation was elicited by comparison of pictures showing six commercially available soft breads with and without packaging. The third section contained knowledge questions of carbohydrates and the carbohydrate debate. A postal invitation to participate in a web-based questionnaire was sent out to a national simple random sample of 3000 respondents, 18-80 years old. An interesting issue to investigate is if the carbohydrate debate has had an impact on bread consumption. Preliminary results will be presented during the congress. 

  • 27.
    Sandvik, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Kihlberg, Iwona
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Consumers’ perception of bread from a health perspective- an exploratory study among a Swedish population2014Conference paper (Other academic)
    Abstract [en]

    Background For strategies to increase the consumption of healthier bread one aspect to explore is consumers’ quality perceptions of bread from a health perspective. Method Survey, response rate 38 % n=1134. Open-ended questions regarding perceptions of healthy bread were content analyzed. Statistics: Correspondence analysis, Mann-Whitney U test and Chi-square. Findings 1/3 had decreased their intake of bread, mainly to maintain/improve health. 1/5 did not know any bread that they considered healthy. Among respondents who did know healthy bread, 1/3 found it hard to identify. Most frequent descriptions of healthy bread were coarse, fiber, wholegrain, sourdough, dark. Most listed health effects were: good for stomach, fiber content, bowel health and satiating. Discussion Increasing consumers’ awareness of different types of breads contribution to a healthy diet is a challenge. The general health perception of bread was in line with recommendations but cues used may be misleading. Health is a credence quality attribute, but health effects that to some extent can be evaluated by the consumer after consumption are more relevant forming health related quality expectation of bread.

     

  • 28.
    Sandvik, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Kihlberg, Iwona
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Sensory and health related characteristics of rye bread in Sweden2014Conference paper (Other academic)
    Abstract [en]

    An important factor for healthy eating is the availability of healthy as well as sensory acceptable food. An increased consumption of rye bread would be beneficial from a health promoting perspective. Previous studies in the present project showed that rye, sourdough and whole grain were perceived as very healthy by consumers. The intake of bread, rich in rye was however low, especially among younger consumers who also had a negative expectation towards the taste. The characteristics of rye bread in Sweden are however not well investigated.

    The aim of the present study was to describe sensory and health related characteristics of rye bread in relation product labels.

    Twenty-four rye bread samples were chosen to represent a wide variety of rye bread on the Swedish market. Sensory descriptive analysis was performed with a trained panel (n=11). Total titratable acidity and pH were measured in all samples as well as fluidity index as an indication of glycemic response on a subset of samples (white wheat bread as reference). Principal Component Analysis (PCA) was used to analyze the sensory space of the products. Front-of-package (FoP) labelling was compared to the characteristics of the products.

    The bread samples sensory characteristics were described for appearance, smell, texture and flavor. According to the PCA, six main groups of rye bread were identified. The rye content of bread with a FoP rye labelling varied from 20 to 100 %. The pH in bread with a FoP sourdough labelling varied from 4,25-5,3. The fluidity index of a subsample of five bread types varied from 51-97 with white wheat bread as a reference (100).

    According these results, the next step is to investigate the consumers’ drivers of rye bread liking.

     

  • 29.
    Sandvik, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Kihlberg, Iwona
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Consumers' health-related perceptions of bread - Implications for labeling and health communication.2018In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 121, p. 285-293Article in journal (Refereed)
    Abstract [en]

    There is a wide variety of commercial bread types and the present study identifies potential pitfalls in consumer evaluations of bread from a health perspective. The aim is to describe consumers' health-related perceptions of bread by exploring which health-related quality attributes consumers associate with bread and whether there are differences with regard to age, gender and education level. A postal and web-based sequential mixed-mode survey (n = 1134, 62% responded online and 38% by paper) with open-ended questions and an elicitation task with pictures of commercial breads were used. Responses were content analyzed and inductively categorized. Three fourths (n = 844) knew of breads they considered healthy; these were most commonly described using terms such as "coarse," "whole grain," "fiber rich," "sourdough," "crisp," "less sugar," "dark," "rye," "seeds," "a commercial brand," "homemade" and "kernels." The breads were perceived as healthy mainly because they "contain fiber," are "good for the stomach," have good "satiation" and beneficial "glycemic properties." The frequency of several elicited attributes and health effects differed as a function of age group (18-44 vs. 45-80 years), gender and education level group (up to secondary education vs. university). Difficulties identifying healthy bread were perceived as a barrier for consumption especially among consumers with a lower education level. Several of the health effects important to consumers cannot be communicated on food packages and consumers must therefore use their own cues to identify these properties. This may lead to consumers being misled especially if a bread is labeled e.g., as a sourdough bread or a rye bread, despite a low content.

  • 30.
    Sandvik, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Kihlberg, Iwona
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Consumers' health-related perceptions of bread - Implications for labeling and health communication2018In: Appetite, Vol. 121, p. 285-293Article in journal (Refereed)
    Abstract [en]

    Purpose: From a health perspective, there is a wide variety of commercial bread types. The aim is to describe consumers’ health-related perceptions of bread by exploring which health-related quality attributes consumers associate with bread and whether there are differences with regard to age and education level.

    Methodology: A postal and web-based sequential mixed-mode survey (n=1134, 63% responded online and 37% by paper). Open-ended questions and an elicitation task with pictures of commercial breads were used. Responses were analyzed for their content and inductively categorized.

    Findings: Three fourths (n=844) knew of breads they considered healthy; these were most commonly described using terms such as “coarse,” “whole-grain,” “fiber rich,” “sourdough,” “crisp,” “less sugar,” “dark,” “rye,” “seeds,” “a commercial brand,” “homemade” and “kernels.” The attributes were perceived as healthy mainly because they “contain fiber” and are “good for the stomach,” or have good “satiation” and beneficial “glycemic properties.” The frequency of several elicited attributes and health effects differed as a function of age group (18-44 vs. 45-80 years) and education level group (up to secondary education vs. university). Difficulties identifying healthy bread were perceived as a barrier for consumption especially among consumers with a lower education level (38%) compared to a higher (28%) (p=.004).

    Originality/value: The present study identifies potential pitfalls in consumer evaluations of bread from a health perspective, particularly in relation to labels and packing. The findings are relevant to health professionals working in dietary counseling as well as to industry when designing packaging and to authorities when drawing up regulations.

  • 31.
    Sandvik, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Næs, Tormod
    Nofima AS, Raw Materials and Process Optimization, Ås, Norway; University of Copenhagen, Department of Food Science, Fredriksberg, Copenhagen, Denmark.
    Kihlberg, Iwona
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Different liking but similar healthiness perceptions of rye bread among younger and older consumers in Sweden2017In: Food Quality and Preference, ISSN 0950-3293, E-ISSN 1873-6343, Vol. 61, p. 26-37Article in journal (Refereed)
    Abstract [en]

    Rye breads, especially those with a chewy texture and sour flavor, have shown several health benefits but their consumption is lower among younger consumers than older. This study explores liking of commercial rye bread in younger and older consumers in relation to socio-demographics, childhood bread-eating habits and food choice motives. Further, sensory attributes are explored in relation to the consumers’ concepts of a rye bread and healthiness in bread.

    Nine commercial rye breads, previously profiled by descriptive sensory analysis were tasted by 225 younger (18–44 years) and 173 older (45–80 years) consumers. Internal preference mappings by principal component regression for each age group showed low liking for rye bread with a chewy texture and sour flavor in the younger consumer group. Based on the preference mappings, the age groups were separately clustered. Associations between clusters and background variables were studied using discriminant partial least squares regression. Liking of rye bread with a chewy texture and sour flavor in the younger consumer group was associated with e.g., more education, females, childhood bread consumption and the food choice motive health. In the older consumer group, it was related to e.g., more education and childhood bread consumption. Partial least squares regression 1 showed that the combination of sensory attributes such as a light color and soft texture led to the perception of bread being less healthy and not a rye bread, and a dark brown color, chewy texture, sour and bitter flavor to the perception of a healthier bread and rye bread.

  • 32.
    Sidenvall, B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fjellström, C
    Andersson, J
    Gustafsson, K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nygren, U
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nydahl, M
    Reasons among older Swedish women of not participating in a food survey2002In: European Journal of Clinical Nutrition, Vol. 56, p. 561-Article in journal (Refereed)
  • 33.
    Sidenvall, Birgitta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nydahl, Margaretha
    Fjellstrom, Christina
    Managing food shopping and cooking: the experiences of older Swedish women2001In: Aeging and Society, Vol. 21, no 2, p. 151-Article in journal (Refereed)
  • 34.
    Simunaniemi, Anna-Mari
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Fruit and vegetable consumption close to recommendations: A partly web-based nationwide dietary survey in Swedish adults2009In: Food and Nutrition Research, ISSN 1654-661X, Vol. 53Article in journal (Refereed)
    Abstract [en]

     Background

    Fruit and vegetables (F&V) are strongly associated with health. The latest Swedish national dietary survey from a decade ago showed that consumption of F&V was below recommended levels. However, current consumption in different subgroups is not well known. 

    Objective

    To investigate the consumption of various F&V types in Swedish adults grouped according to sociodemographic factors and self-reported physical activity (PA).

    Design

    A cross-sectional survey using a quantitative pen-and-paper or web-based questionnaire in a population-based random sample of adults 18–84 years (final n=1,304; 51%). A self-administered 24-h recall and a food frequency questionnaire (FFQ) were used to measure F&V consumption. Data on gender, age, education level, country of birth, and PA (hours/week) were included as grouping variables. Besides descriptive data, two-sample t-tests and non-parametric tests were performed. A P-value <0.01 was regarded as significant.

    Results

    Mean F&V consumption based on the self-administered 24-h recall was close to the recommended five portions/day: 5.4 (99% CI 5.1–5.6) portions/day among women and 4.7 (4.4–5.0) portions/day among men (P<0.001). Also the FFQ showed that women generally consumed more F&V than men did. Consumption was lowest among respondents with ≤ 0.5 h self-reported PA/week (P≤0.001), as well as among men born in Sweden (P=0.006). F&V were consumed in almost equal amounts, and fresh F&V were most popular. Intake of berries and cooked F&V was relatively low.

    Conclusion

    The present study shows a relatively high F&V consumption close to the recommended five portions per day. Gender differences still exist. Also PA and country of birth were significantly associated with F&V consumption.

  • 35.
    Simunaniemi, Anna-Mari
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Cluster Analysis of Fruit and Vegetable Related Perceptions: An Alternative Approach of Consumer Segmentation2013In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 26, no 1, p. 38-47Article in journal (Refereed)
    Abstract [en]

    Background:  Audience segmentation optimises health communication aimed to promote healthy dietary habits, such as fruit and vegetable (F&V) consumption. The present study aimed to segment respondents into clusters based on F&V-related perceptions, and to describe these clusters with respect to F&V consumption and sex.

    Methods:  The cross-sectional study was conducted using a semi-structured questionnaire. The respondents were randomly selected among Swedish adults (n = 1304; response rate 51%; 56% women). A two-step cluster analysis was conducted followed by a binary logistic regression with cluster membership as a dependent variable. The clusters were compared using t-tests and chi-squared tests. P < 0.05 (two-sided) was considered statistically significant. The respondents’ open-ended answers of determinants of F&V consumption were used as a descriptive support for the conducted multivariate analysis.

    Results:  Of the two identified clusters, the Positive cluster (n = 476) was older and consumed more vegetables (both sexes) and fruit (women only), whereas men in the Indifferent cluster (n = 715) consumed more juice. Indifferent cluster reported more F&V consumption preventing factors, such as storage and preparation difficulties and low satisfaction with F&V selection and price. Not liking or not having a habit of F&V consumption, laziness, forgetting and a lack of time were mentioned as main barriers to F&V consumption.

    Conclusions:  The Indifferent cluster reports more practical and life-style related difficulties. The Positive cluster consumes more vegetables, perceives fewer F&V-related difficulties, and looks for more dietary information. The findings confirm that cluster analysis is an appropriate way of identifying consumer subgroups for targeted health and nutrition communication.

  • 36.
    Simunaniemi, Anna-Mari
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Sandberg, Helena
    Media and Communication Studies, Lund universitet.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Laypeople blog about fruit and vegetables for self-expression and dietary influence2011In: Health Communication, ISSN 1041-0236, E-ISSN 1532-7027, Vol. 26, no 7, p. 621-630Article in journal (Refereed)
    Abstract [en]

    Private health information websites run by laypeople are more often visited than websites of official agencies. Understanding the role of weblogs in dietetic communication-i.e., sharing personal perceptions on healthy eating-is still lacking. This study aims to describe the nature of noncommercial Swedish blogs with fruits and vegetables (F&V)-related content and to identify different blogger types. A qualitative content analysis with abduction was performed on 50 weblogs. Most bloggers presented themselves as women. Only one-third reported their age (range 17 to over 50 years). The bloggers had either an active or passive influential purpose, and they approached F&V through either lived or mediated experiences. From these two dimensions, four F&V blogger ideal types were identified: the Persuader, the Authority, the Exhibitionist, and the Mediator. Particularly women wrote about their lived experiences close to the personal level, whereas men were more equally distributed across the different ideal types. Self-expression (typical for the Exhibitionist) and purpose to influence others' diets (typical for the Persuader and the Authority) were frequently expressed in these weblogs. The current findings on blogging purposes, approaches, and F&V blogger types may help to improve online dietetic communication, which sets new challenges for media strategies of health and nutritional professionals.

  • 37.
    Simunaniemi, Anna-Mari
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Sandberg, Helena
    Lunds universitet, Lund University.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Normative, Authentic and Altruistic Fruit and Vegetable Consumption as Weblog Discourses2013In: International Journal of Consumer Studies, ISSN 1470-6423, E-ISSN 1470-6431, Vol. 37, no 1, p. 66-72Article in journal (Refereed)
    Abstract [en]

    The Internet is a growing information and communication channel for health- and diet-related issues. Keeping updated on the fruit- and vegetable-related (F&V) discourses among laypeople is important for health communicators in order to promote F&V consumption through tailored health messages. The aim of the present study was to identify F&V-related discourses in weblogs that were maintained, obviously, to influence diet. A theoretically chosen sample of weblogs were analysed applying critical discourse analysis. The analysis showed three partly overlapping F&V-related discourses: (1) normative consumption with a focus on single nutrients and physiological mechanisms; (2) authentic consumption with a desire for naturalness; and (3) altruistic consumption where ethical responsibilities are enhanced. Bloggers have clear perceptions on ideal F&V consumption, but it is a challenge for the reader to make a synthesis of the discourses presented. Filtering contradictory instructions requires health literacy, which may need more support from dietetic professionals.

  • 38.
    Skinnars Josefsson, Malin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Mattsson Sydner, Ylva
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Access to competence and policy- food provision in Swedish eldercare2014Conference paper (Refereed)
    Abstract [en]

    Introduction: To provide food and meals in elderly care is a growing concern in the welfare state.  Objective:  Investigate and compare nutritional competence and its relation to different kind of food policies within elderly care in Swedish municipalities, in 2006 and 2013-14. Methodology: Web based questionnaires were distributed to all Swedish municipalities (N= 290) twice. Results:  Access to clinical- and administrative dietitians differ between analyzed years and between sizes of municipalities. Nutritional competences correlated with local policies in 2006 and the national guideline (introduced in 2011) 2013-14. Conclusion: Municipal size and nutritional competence are central in strategic food provision work.

  • 39.
    Skinnars Josefsson, Malin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Mattsson Sydner, Ylva
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    National survey in elderly care on the process of adopting a new regulation aiming to prevent and treat malnutrition in Sweden2018In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 26, no 6, p. 960-969Article in journal (Refereed)
    Abstract [en]

    Guided by the i-PARIHS framework, this study investigates perceived facilitators in the process of adopting a new regulation launched in 2015 which aims to prevent and treat malnutrition. In May 2016, a national web-based questionnaire was emailed to chief medical nurses in elderly care in all Swedish municipalities (n = 290). The response rate in this cross-sectional study was 75% (n = 217). Fifty per cent of the municipalities had adopted new routines, 42% had started and 8% had not. One third of the respondents considered malnutrition to be a major problem in elderly care and about half considered the new national regulation to have strengthened local work. A logistic regression showed that the odds for having adopted new routines were higher for CMNs with long experience in elderly care and who had previously worked to prevent malnutrition, and for those who considered the new national regulation helpful. To extract underlying factors in the adoption process, two principal component analyses were performed for key actors and support. For key actors, the analysis yielded four factors, explaining 67% of the total variance; (a) first line team, (b) expert team, (c) management team and (d) surrounding resources. For support, the analysis yielded three factors, which explained 65% of the total variance; (a) agile teamwork, (b) management and leadership and (c) acceptance. The slow adoption rate of the regulation raises questions about its impact; this might be an effect of the general trend of decentralisation in the Swedish welfare sector, and in elderly care in particular, making it hard to attain change that is steered centrally. However, malnutrition is a pronounced problem in elderly care and the mandatory nature of the new regulation therefore warrants further investigation of whether its launch has contributed to a reduction of malnutrition by investigating outcomes and preventive actions carried out in practice.

  • 40.
    Skinnars Josefsson, Malin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Persson, Inger
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Statistics.
    Mattsson Sydner, Ylva
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Adherence to a regulation that aims to prevent and treat malnutrition: the case of Swedish elderly care2019In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 123, no 7, p. 688-694Article in journal (Refereed)
    Abstract [en]

    Malnutrition constitutes a serious and challenging problem in elderly care. In 2015, a Swedish regulation that aims to prevent and treat malnutrition came into effect. This study set out to explore associations between level of adoption of the regulation reported as: no, started, yes, in a previous survey, and registrations in a national quality registry. Registry data on screening and actions extracted from the first trimester in 2014 (n=18967), 2016 (n=20318) and 2017 (n= 25669) represented 209, 197 and 199 of 290 Swedish municipalities respectively. A repeated measures ANOVA showed that there was no effect on screened nutritional status, Pearson's chi-square that there were minor differences in types of actions, and regression analysis that the number of actions increased on average by 0.3 due to a higher level of adoption of the regulation. Over the years studied, five actions were prominent regardless of level of adoption or screened nutritional status. Hence, to date, no firm conclusions regarding effects of the regulation can be drawn. Despite the regulatory nature, it appear as if the regulation and the level of adoption reported so far is routine in theory, although not yet leveraged to an implemented practice visible in the quality registry but instead decoupled from practice.

  • 41.
    Skinnars Josefsson, Malin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Persson, Inger
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Statistics.
    Mattsson Sydner, Ylva
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Quality indicators of nutritional care practice in elderly care2017In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no 9, p. 1057-1064Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim is to explore the effects of antecedent, structural and process quality indicators of nutritional care practice on meal satisfaction and screened nutritional status among older adults in residential care homes. Design: Data for this Swedish cross-sectional study regarding older adults living in residential care homes were collected by i) a national questionnaire, ii) records from the quality registry Senior Alert, iii) data from an Open Comparison survey of elderly care in 2013/2014. The data represented 1154 individuals in 117 of 290 Swedish municipalities. Measurements: Meal satisfaction (%) and adequate nutritional status, screened by the Mini Nutritional Assessment Short Form (MNA-SF), were the two outcome variables assessed through their association with population density of municipalities and residents’ age, together with 12 quality indicators pertaining to structure and process domains in the Donabedian model of care. Results: Meal satisfaction was associated with rural and urban municipalities, with the structure quality indicators: local food policies, private meal providers, on-site cooking, availability of clinical/community dietitians, foodservice dietitians, and with the process quality indicators: meal choice, satisfaction surveys, and ‘meal councils’. Adequate nutritional status was positively associated with availability of clinical/community dietitians, and energy and nutrient calculated menus, and negatively associated with chilled food production systems. Conclusion: Municipality characteristics and structure quality indicators had the strongest associations with meal satisfaction, and quality indicators with local characteristics emerge as important for meal satisfaction. Nutritional competence appears vital for residents to be well-nourished.

  • 42.
    Skinnars Josefsson, Malin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Persson, Inger
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Statistics.
    Mattsson Sydner, Ylva
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Reforming Foodservice in Elderly Care: National Actions and Local Outcomes2018In: Nutrition & Dietetics, ISSN 1446-6368, E-ISSN 1747-0080, Vol. 75, no 1, p. 79-86Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to explore the outcome, on a local level, of steering, organisation and practices of elderly care foodservice by Swedish municipalities, and changes relative to national actions.

    Methods: A survey using a web-based questionnaire about elderly care foodservice targeting all Swedish municipalities (n=290) was conducted in 2006 and 2013/14. The questionnaire included the topics: organisation of foodservice, its practice in elderly care, and steering devices such as guidelines and policies. Based on the share of a rural population, municipalities were divided into groups: rural (≥50%), urban (<50%) and city (≤20%).

    Results: The response rate from municipalities was 80% in 2006 and 56% in 2013/14; 45% participated in both surveys. The results showed increased use of local food policies (P=0.03) and meal choice (P<0.001), while access to clinical/community dietitians declined (P=0.01) between the surveys. In home-help services, daily delivered cook-serve meals declined (P<0.001) and chilled meals delivered three times a week increased (P=0.002) between the surveys. City municipalities used private foodservice organisations the most, (P<0.001) and reported reduced use of cook-serve systems in favour of chilled. In rural municipalities, the use of public providers (98%) and a cook-serve system (94%) were firmly established. Urban municipalities were placed between the other groups.

    Conclusions: National actions such as soft governance and benchmarking appear largely to determine local level outcomes. However, conditions for adapting these measures vary between municipality groups. While efficiency enhancing trends were prominent, questions remain whether national actions should be expanded beyond performance to also examine their consequences.

  • 43. Smith, Ruth D
    et al.
    Kelly, Colette N.M
    Renuka Silva, K.D.R
    Nydahl, Margaretha
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Williams, Christine M
    Effects of substituting dietary saturned fatty acids with monounsaturated fatty acids in young healthy volunteers2000In: The nutition Society Summer meeting in Costa Irland 28/6-30/6, 2000Conference paper (Other scientific)
  • 44.
    Tydén, Tanja
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Stern, Jenny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Berglund, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Larsson, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Rosenblad, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Pregnancy planning in Sweden: a pilot study among 270 women attending antenatal clinics2011In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 90, no 4, p. 408-412Article in journal (Refereed)
    Abstract [en]

    Objective

    Health status and lifestyle before and at the time of conception could affect the health of both mother and child, but there is a lack of knowledge about the degree to which pregnancies are planned. The aim of this pilot study was to investigate whether and how women plan their pregnancies.

    Material and methods

    The main outcome measures were use of timetables, ovulation tests and lifestyle changes. Women (n = 322) visiting four antenatal clinics were asked to fill out a questionnaire (participation rate = 83.9%, n = 270).

    Results

    Three of four pregnancies (n = 202) were very or rather well planned, whereas 4.4% (n = 12) were totally unplanned. During the planning period, 37.1% (n = 100) made up a timetable for getting pregnant, 23% (n = 62) used ovulation tests, 20.7% (n = 56) took folic acid and 10.4% (n = 28) changed alcohol consumption.

    Conclusion

    Although a majority of these women had planned pregnancies, only one in five had taken folic acid during the planning period.

  • 45. Vintila, Mona
    et al.
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Maragertha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Istrat, Daniala
    West University of Timosara.
    Kuglis, Amalia
    West University of Timosara.
    Health awareness and behavour of the elderly: between needs and reality: A comparative study2009In: Romanian Journal of Applied Psychology, ISSN 1454-8062, Vol. 11, no 2, p. 81-87Article in journal (Other academic)
    Abstract [en]

    Social factors such as social cohesion, the role of the voluntary services and social engagement cannot be influenced by traditional preventive and health promotion initiatives. There is a need for innovative strategies in health promotion. Taking account of the variety of approaches observable in European countries, the idea has arisen of starting a multinational project to develop new solutions to the problem of implementing healthy lifestyles in the local communities of different countries. The project involves 10 partners from six countries: Germany, Great Britain, Sweden, Austria, Latvia and Romania. The following results present an analysis of some comparative data of the Swedish and Romanian communities. Attitudes about health and behavior in terms of maintaining health are very different in Romania and Sweden. These differences very likely reflect the level of information on health, nutrition, physical activity and sources of information. The study highlighted some differences in the eating habits of the two groups of subjects.

  • 46.
    von Berens, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Fielding, R. A.
    Gustafsson, T.
    Kirn, D.
    Laussen, J.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Travison, T. G.
    Reid, K.
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Physical performance and serum 25(OH)vitamin D status in community dwelling old mobility limited adults: A cross-sectional study2018In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 22, no 1, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Objectives:

    To examine the potential association between serum 25(OH) vitamin D and theperformance on the Short Physical Performance Battery (SPPB) including the sub-components; five repeatedchair stands test, 4 meters walk test and balance in older mobility-limited community-dwelling men and women.

    Design:

    A cross sectional study was performed in American and Swedish subjects who were examined forpotential participation in a combined exercise and nutrition intervention trial. Logistic regression analysis andlinear regression analyses were performed to evaluate the association for 25(OH)D with the overall score onthe SBBP, chair stand, gait speed and balance.

    Participants:

    Community-dwelling (mean age 77.6 ± 5.3 years)mobility limited American (n=494) and Swedish (n=116) females (59%) and males.

    Measurements:

    The SPPB(0-12 points) includes chair stand (s), gait speed (m/s) and a balance test. Mobility limitation i.e., SPPB score ≤9 was an inclusion criterion. A blood sample was obtained to measure serum 25(OH)vitamin D concentrations.

    Results:

    No clear association of 25(OH)D with SPPB scores was detected either when 25(OH)D was assessedas a continuous variable or when categorized according to serum concentrations of <50, 50-75 or <75 nmol/L.However, when analyzing the relationship between 25(OH)D and seconds to perform the chair stands, asignificant quadratic relationship was observed. Thus, at serum levels of 25(OH)D above 74 nmol/L, higherconcentrations appeared to be advantageous for the chair stand test, whereas for serum levels below 74 nmol/Lthis association was not observed.

    Conclusion:

    This cross- sectional study lacked clear association betweenserum 25(OH)D and physical performance in mobility limited adults. A potentially interesting observation wasthat at higher serum levels of 25(OH)D a better performance on the chair stand test was indicated.

  • 47.
    von Berens, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Fielding, Roger A.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA.
    Gustafsson, Thomas
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden.
    Kirn, Dylan
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA.
    Laussen, Jonathan
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Reid, Kieran
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA.
    Travison, Thomas G.
    Harvard Med Sch, Boston, MA USA;Beth Israel Deaconess Med Ctr, Div Gerontol, Boston, MA 02215 USA;Hebrew SeniorLife, Inst Aging Res, Boston, MA USA.
    Zhu, Hao
    Hebrew SeniorLife, Inst Aging Res, Boston, MA USA.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: the VIVE2 randomized controlled trial2018In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, article id 286Article in journal (Refereed)
    Abstract [en]

    Background: Health-related quality of life (HRQoL) and absence of depressive symptoms are of great importance for older people, which may be achieved through lifestyle interventions, e.g., exercise and nutrition interventions. The aim of this investigation was to analyze the effects of a physical activity program in combination with protein supplementation on HRQoL and depressive symptoms in community-dwelling, mobility-limited older adults. Methods: In the Vitality, Independence, and Vigor 2 Study (VIVE2), community-dwelling men and women with an average age of 77.55.4 years, some mobility limitations and low serum vitamin D levels (25(OH)Vit D 22.5-60 nmol/l) from two study sites (Stockholm, Sweden and Boston, USA) were randomized to receive a nutritional supplement or a placebo for 6 months. All took part in a physical activity program 2-3 times/week. The primary outcome examined in VIVE2 was 400 M walk capacity. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Health Survey (SF36), consisting of the Physical Component Summary (PCS) and Mental Component Summary (MCS), and depressive symptoms were measured using The Centre for Epidemiologic Studies Depression Scale (CES-D). In the sensitivity analyses, the sample was divided into sub-groups based on body measures and function (body mass index (BMI), appendicular lean mass index (ALMI), handgrip strength and gait speed). Results: For the whole sample, there was a significant improvement in both MCS, mean (95% CI) 2.68 (0.5, 4.9) (p 0.02), and CES-D -2.7 (-4.5, -0.9) (p 0.003) during the intervention, but no difference was detected between those who received the nutritional supplement and those who received the placebo. The results revealed no significant change in PCS or variation in effects across the sub-categories. Conclusions: This study demonstrates that a six-month intervention using a physical activity program had positive effects on mental status. No additional effects from nutritional supplementation were detected.

  • 48.
    von Berens, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Fielding, R. A.
    Gustafsson, T.
    Kirn, D. R.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Södergren, M.
    "Feeling more self-confident, cheerful and safe”. Experiences from a health-promoting intervention in community dwelling older adults — A qualitative study2018In: Journal of Nutrition Health and Aging, Vol. 22, no 4, p. 541-548Article in journal (Refereed)
    Abstract [en]

    Objectives: Studies show that regular exercise in combination with nutritional support can be effective in managing sarcopenia, which is age-related involuntary loss of skeletal muscle mass and strength. Qualitative investigations of participants' experiences from interventions in this domain are scarce. In this study, we explored older persons' experiences from an intervention designed to prevent sarcopenia, with the aim of capturing the participants' thoughts and opinions.

    Design: A qualitative study embedded in the multicenter randomized clinical trial The Vitality and Vigor in the Elderly study, VIVE2. Focus group interviews were conducted. Manifest and latent content analyses were performed.

    Participants: Community dwelling older adults (n=20) 71-86 years of age with minor limitations in mobility.

    Results: The experiences from the intervention were categorized and interpreted in one overall theme "Feeling more self-confident, cheerful and safe". The theme encompasses the categories psychological effects of participating in the intervention, physical effects of participating in the intervention, the importance of social support and the importance of a tailored set-up. The participants described their motives for participating in the intervention as being based on concerns regarding the negative health effects of continuing a sedentary lifestyle, difficulties of getting started on their own and lack of confidence in accomplishing change on their own. Participants also expressed that one main objective for participating was to lose weight.

    Conclusion: In this study we have captured the experiences of older adults with minor mobility limitations who participated in a lifestyle intervention. The experiences are interpreted in one overall theme "Feeling more self-confident, cheerful and safe". The central understanding of the participants' experiences was that the intervention affected them in several ways, both psychologically and physically, and that supporting factors included the social support, which became a prerequisite for success. A noticeable finding was the discrepancy between the motive of the participants, to lose weight, and the aim of the study, to improve muscle function. The expectation to lose weight seems to reflect what is commonly known as to be healthy. To our knowledge, at least in Sweden, there are no campaigns or public information highlighting the risks of sarcopenia and the complex issue of if, and when weight loss is desirable for older individuals. This finding highlights the importance of providing such information to this target group. The findings in this study provide valuable knowledge for research teams, practitioners and decision makers when designing and setting objectives for health-promoting interventions for older individuals.

  • 49.
    von Berens, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Dept. of Public Health and Caring Sciences/ Clinical Nutrition and Metabolism, Uppsala University.
    R Obling, Sine
    Department of Medical Gastroenterology, Odense University Hospital, Denmark.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lissner, Lauren
    Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg.
    Skoog, Ingmar
    Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology Unit, University of Gothenburg.
    Frändin, Kerstin
    Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology Unit, University of Gothenburg.
    Rothenberg, Elisabet
    Kristianstad University, Food and Meal Science.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Sarcopenic obesity and associations with mortality- a prospective observational studyManuscript (preprint) (Other academic)
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